“to thine own self be true” and prostate cancer treatment decision making

If what you have done yesterday still looks big to you, you haven’t done much today.~ Mikhail Gorbachev

I have playing around with these Polldadday polls and the question about “which treatment do you think gives you the best chance at cure.” Well the overwhelming response is surgical removal. Well if that is the prevailing opinion, then why all fuss about alternative therapy particularly proton therapy.

Is proton therapy chosen because it is felt to be the very best chance at cure?

Or…could it be that it is that mode of therapy that balances cure vs. risk?

So when you go about evaluating the various forms of therapy for your prostate cancer….”To thine own self be true.” Define exactly what is most important to you and clarify to yourself exactly why you have picked a form of therapy.

Does it mean anything to you that the candidates for proton therapy are in the low/intermediate risk prostate cancer? That one is low risk is based on the prostate biopsy. What if the prostate biopsy doesn’t give the true extent of your disease? Hummmmmmmm!

For a 70-year-old/Gleason 6 patient like me to emerge from radical prostatectomy (either robotic or open) with a trifecta of (a) all cancer removed, (b) no incontinence, and (c) at least as much sexual function as I had going in requires both a skilled surgeon with great hands and at least 1,200 prostatectomies behind him AND a big dose of good luck. The stories of those whose luck wasn’t so good are endemic.

Although head-to-head after-treatment statistics are hard to come by, what I have seen suggests that proton therapy, the odds of a trifecta in my case are above 95%, no luck required. I’m not in the habit of playing the lottery or rolling the dice.

Without exception, everyone I know who has gone through proton therapy–including those who had it 10+ years ago–is a great supporter. Can you say that about RP?

Nonetheless, as you point out in your book, John, what’s right for me isn’t necessarily right for my neighbor.

very nicely put….again…i am only a proponet of certain therapies for certain patients with certain disease parameters…..
i am a bit suspicious of patients or books that tout that a particular treatment is the “end all do all” treatment for everybody.
i agree with your sentiments and “minimizing risk” 100%- thanks for the comment. jm